methods

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records flow

results

forestplot

Study Characteristics

author (year) cohort name study sample size cohort sample size (pre) cohort sample size (post) cohort sample size (final follow-up) attrition rate post intervention attrition rate at final follow-up nationality % females mean age (sd) patient group minimum pain duration mean pain duration in months pain_duration_sd
Abbasi (2012) a Spouse Assisted Multidisciplinary pain management program 36 10 9 9 10.00 10.00 Iran 88.00 45 (10) age: 18-70, married, longer than 6 months with low back pain 6 months 74 (median) NA
Abbasi (2012) b Patient-oriented multidisciplinary pain management program NA 12 12 10 0.00 16.67 NA NA NA (NA) NA NA NA NA
Beaudreuil (2010) a Functional restoration program 39 39 39 39 0.00 0.00 France 28.00 42.9 (8.2) Low back pain 3 28.6 32
Bendix (1998) a Functional restoration (A) 238 55 47 44 14.55 20.00 Denmark 67.40 42 (NA) chronic low back pain 6 months NA NA
Bendix (1998) b Functional restoration (B) NA 46 41 37 10.87 19.57 NA 70.27 41 (NA) NA NA NA NA
Bendix (2000) a Functional Restoration 138 59 51 48 13.56 18.64 Denmark 66.10 42.1 (NA) Precarious work situation because of low back pain (e.g. in danger of losing their job). Chronic low back pain. NA ? NA
Bergstrom (2014) a Multimodal rehabilitation 43 43 39 34 9.30 20.93 Sweden 80.00 41 (NA) Disabling chronic pain 6 NA NA
Bileviciute-Ljungar (2014) a rehabilitation cohort (1998) 88 NA NA 19 NA NA Sweden 84.00 43.2 (2.1) persistent musculoskeletal pain NA NA NA
Bilveviciute-Ljungar (2014) b Rehabilitation (2003) NA NA NA NA NA NA NA 89.47 39.5 (1.9) NA NA NA NA
Borys (2015) a multimodal therapy 155 155 155 63 0.00 59.35 Germany 55.60 58.3 (10.4) chronic low back pain as predominant condition; indication for attending MMT; sufficient understanding of German language 3 months 217.2 172.8
Brendbekken (2016) a Multidisciplinary intervention 284 141 137 85 2.84 39.72 Norway 53.90 41.3 (NA) musculoskeletal pain NA NA NA
Cardosa (2012) a MENANG program 102 70 70 70 0.00 0.00 Malaysia 64.30 42.87 (9.87) chronic pain 3 months 66.81 65.37
De Rooij (2014) a Multidisciplinary treatment programme 138 133 NA 114 NA 14.29 Netherlands 95.00 45.04 (10.3) Chronic widespread pain NA 84 NA
Dysvik (2013) a Multidisciplinary pain management programme 117 117 104 95 11.11 18.80 Norway 79.00 45 (11.25) chronic non-malignant pain 6 months 89.9 NA
Frost (2000) a functional restoration 129 123 121 97 1.63 21.14 United Kingdom 45.00 43 (9) constant pain 12 months NA NA
Gantschnigg (2017) a BAI-REHA 30 24 23 24 4.17 0.00 Swiss 43.00 44.83 (12.57) ICD-10 diagnosis of chronic musculoskeletal pain NA NA NA
Grahn (2000) a Multidisciplinary rehabilitation 236 122 NA 113 NA 7.38 Sweden 82.00 44.3 (9.1) • Prolonged musculoskeletal disease as main diagnosis NA 68.4 73.2
Gustafsson (2002) a multimodal, multidisiciplinary outpatient rehabilitation programme 23 23 22 17 4.35 26.09 Sweden 100.00 43.8 (10.7) Fibromyalgia or widespread chronic pain NA 13.2 (years) 9.8 (years)
Hafenbrack (2013) a Berlin 681 560 544 242 2.86 56.79 Germany 49.20 45.54 (9.42) back pain NA NA NA
Hafenbrack (2013) b Hamburg NA 157 152 68 3.18 56.69 NA NA NA (NA) NA NA NA NA
Haiduk (2017) a Zurzacher Interdisziplinäres HWS Konzept (ZIHKo) 115 115 NA 59 NA 48.70 Switzerland 83.10 40.3 (12.3) chronic neck pain 3 months 17.2 23.6
Hallstam (2016) a Multimodal rehabilitation 42 42 NA 29 NA 30.95 Sweden 90.50 43.6 (15.7) complex pain problems NA
25 months pain (83% of the cohort)
NA
Hazard (1988) a Functional restoration 64 59 58 37 1.69 37.29 USA 36.00 37 (4.3) Low back pain 4 months NA NA
Heikkilä (1998) a Multidisciplinary pain rehabilitation program 73 73 65 56 10.96 23.29 Sweden 64.38 36.5 (NA) Whiplash trauma and other myofascial pain NA Mean sick leave in the 2-years before: 331 days (range 0-730) NA
Jensen (1997) a multimodal cognitive behavioral treatment only (regular intervention) 63 30 28 25 6.67 16.67 Sweden 100.00 43 (9) nonspecific spinal pain without neurological signs NA 51 68
jensen (1997) b Multimodal cognitive behavioral treatment (experimental program) NA 33 31 29 6.06 12.12 NA 100.00 45 (8) NA NA 44 66
Kääpä (2006) a Multidisciplinary rehabilitation program 64 64 59 49 7.81 23.44 Finland 100.00 46 (7.9) Low back pain 1 year 16 25
Koopman (2004) a Multidisciplinary Occupational Training Program 68 68 64 51 5.88 25.00 Netherlands 47.10 NA (41.2) Low back pain 6 72 96.78
Lemstra (2005) a Multidisciplinary rehabilitation 43 43 36 35 16.28 18.60 Canada 86.00 49.7 (9.57) Chronic widespread pain 6 121.7 128.36
Mangels (2009) a Behavioral-medical rehabilitation 363 113 113 106 0.00 6.19 Germany 78.80 49.5 (9) Musculoskeletal pain NA NA NA
Mangels (2009) b Behavioral-medical rehabilitation+booster NA 119 119 111 0.00 6.72 NA 75.60 48.3 (15.8) NA NA NA NA
Martin (2012) a PSYMEPHY 180 120 108 93 10.00 22.50 Spain 93.46 49.07 (8.92) Fibromyalgia 6 months 174.22 119.52
McAllister (2005) a Multidisciplinary chronic pain program 276 276 219 99 20.65 64.13 United States 66.30 44.7 (9.7) chronic non-malignant pain 6 NA NA
Merrick (2009) a Interdisciplinary rehabilitation 255 168 165 167 1.79 0.60 Sweden 79.00 39 (NA) Disabling chronic pain 6 43 (median) NA
Monticone (2013) a Multidisciplinary intervention 90 45 45 45 0.00 0.00 Italy 60.00 48.96 (7.97) chronic non-specific low back pain 3 months 22.15 11.9
Monticone (2016) a multidisciplinary cognitive behavioural rehabilitation programme 150 75 74 65 1.33 13.33 Italy 62.67 53.2 (11.1) non-specific low back pain 3 months 21.7 15
Olason (2004) a interdisciplinary pain management program 158 158 120 NA 24.05 NA Iceland 70.90 39.5 (NA) Chronic pain NA 67% > 24 maanden, 49.3% more than 5 years NA
Persson (2012) a musculoskeletal interdisciplinary pain rehabilitation program 509 509 NA 509 NA 0.00 Sweden 79.00 40 (9.6) musculoskeletal pain NA 49.2 54.24
Reck (2017) a Interdisciplinary multimodal pain therapy 71 69 NA 41 NA 40.58 Switzerland 54.00 43.59 (11.84) chronic non-specific low back pain NA 44.4% more than 5 years NA
Richardson (1994) a pain management course 109 109 99 109 9.17 0.00 United Kingdom 68.00 45 (10) chronic pain • referred from pain clinics; GPs, hospital specialists 128 114
Roche (2011) a Functional Restoration 132 68 NA 64 NA 5.88 France 32.40 40.8 (7.4) non-specific LBP 3 NA NA
Semrau (2014) a PASTOR 554 280 266 193 5.00 31.07 Germany 54.10 48.9 (8) low back pain 3 NA NA
Silvemark (2014) a Pain rehabilitation programme 164 154 133 68 13.64 55.84 Sweden 69.50 37.4 (9.07) long-term non-malignant pain NA 68.4 21.9
Smeets (2008) a Graded activity with problem solving training 223 58 55 52 5.17 10.34 Netherlands 58.60 42.52 (9.67) non-specific low-back pain 3 68.33 74.21
smeets (2008) b combination treatment NA 61 55 53 9.84 13.11 NA 37.70 40.67 (10.14) NA NA 56.13 67.5
spinhoven (2004) a merged cohorts: operant-behavioral treatment + coping or group discussion (OPCO/OPDI) 148 117 103 90 11.97 23.08 Netherlands 63.50 39.8 (9.1) Low back pain 6 117.6 104.4
Stein (2013) a Multidisciplinary rehabilitation 169 59 59 51 0.00 13.56 Sweden 86.00 48 (7.8) chronic non-cancer pain 3 NA 135.4
Tavafian (2011) NA Group-based multidisciplinary rehabilitation program 197 97 93 69 4.12 28.87 Iran 73.20 44.6 (10.2) chronic low back pain 3 months 75.9 71.4
Thieme (2003) a Operant pain therapy 40 40 40 40 0.00 0.00 Germany 100.00 46.61 (8.67) Fibromyalgia ACR criteria 17.05 years 7.12 years
Van der Maas (2015) a pain rehabilitation 114 57 33 26 42.11 54.39 Netherlands 71.10 45.4 (11.1) chronic musculoskeletal pain NA NA NA
Van der Maas (2015) b Rehabilitation treatment + body awareness NA 49 45 23 8.16 53.06 NA 91.80 38.6 (11.1) NA NA NA NA
van Eijk-Hustings (2013) a Multidisciplinary treatment 203 108 67 67 37.96 37.96 Netherlands 93.51 41.49 (9.64) fibromyalgia 3 months 82.08 75.84
van Hooff (2010) a Pain management programme 107 107 82 82 23.36 23.36 Netherlands 57.00 44.1 (8.4) Low back pain 6 12.3 (years) 10.9 (years)
van Wilgen (2009) a Inpatient multidisciplinary CBT programme 32 26 26 26 0.00 0.00 Netherlands 73.00 42 (11) chronic pain 12 months 96 84
Vendrig (2000) a Multidisciplinary behavioural program for chronic pain 147 143 NA 130 NA 9.09 Netherlands 31.00 41.6 (8.5) chronic low back pain; treated in 1996; aim to return to work NA 46.3 NA
Verkerk (2011) a Functional recovery 1760 1760 1696 965 3.64 45.17 Netherlands 74.26 40.1 (10.6) chronic non-specific low back pain 3 92.4 105.6
Westman (2009) a early multimodal rehabilitation 91 91 NA 72 NA 20.88 Sweden 70.00 41.5 (NA) Musculoskeletal pain and disability NA Duration of sick leave period before program in months: 2 0.9
author (year) treatment aim treatment modalities healthcare providers type of treatment follow-up sessions time span (weeks) duration tailoring
Abbasi (2012) a General aim of treatment: General aim of treatment programs: improving patients’ pain management skills, physical capacities and psychological functioning. Specific aim of Spouse assistance: spousal response to the development and maintenance of chronic pain and the need to involve partners in treatment efforts are increasingly being acknowledged as important elements to address through treatment education, (cognitive) behavioral therapy, relaxation, pain management skills, Other Physician (rehabilitation, occupational, general), psychologist (clinical psychologist, behavioral therapist), physiotherapist (physical therapist), other outpatient
Mixed (6)
face-to-face
pain clinic
NA 7 1445m NA
Abbasi (2012) b NA education, (cognitive) behavioral therapy, relaxation, pain management skills, Other Physician (rehabilitation, occupational, general), psychologist (clinical psychologist, behavioral therapist), physiotherapist (physical therapist), other NA
Mixed
face-to-face
pain clinic
NA 7 1550m NA
Beaudreuil (2010) a na; General aim of treatment programs: Functional restoration therapy (FRT) is an intensive multidisciplinary approach to the management of incapacitating low back pain to improve overall disability and work ability. exercise, relaxation, Other Physician (rehabilitation, occupational, general), physiotherapist (physical therapist), occupational therapist (ergo therapist), social worker (counsellor), other outpatient
Group (2-6)
face-to-face
hospital
NA 5 13730m Low
Bendix (1998) a to restore the patients’ physical, psychosocial, and socioeconomic situation by focusing on active functioning. education, exercise, (cognitive) behavioral therapy, relaxation, Other Physician (rehabilitation, occupational, general), psychologist (clinical psychologist, behavioral therapist), physiotherapist (physical therapist), occupational therapist (ergo therapist), social worker (counsellor, advisor), other outpatient
Group (6-8)
face-to-face
pain clinic
NA 3 135 NA
Bendix (1998) b NA NA NA NA
NA
NA
NA
NA NA NA NA
Bendix (2000) a Focused on self-responsibility, activity and a multidisciplinary approach. education, exercise, relaxation, pain management skills, Other Physician (rehabilitation, occupational, general), psychologist (clinical psychologist, behavioral therapist), physiotherapist (physical therapist), occupational therapist (ergo therapist) outpatient
Group
face-to-face
hospital
NA 3 117 NA
Bergstrom (2014) a General arm: to attain a higher level of body awareness and perceived health. Main goal: decreased sick leave and rtw. education, exercise, relaxation, pain management skills, body awareness therapy, team meetings, Other Physician (rehabilitation, occupational, general), psychologist (clinical psychologist, behavioral therapist), physiotherapist (physical therapist), occupational therapist (ergo therapist), social worker (counsellor, advisor) outpatient
Group (10-12)
face-to-face
hospital
NA 5 NA Low
Bileviciute-Ljungar (2014) a higher level of activity, rtw, pain reduction. education, exercise, pain management skills, workplace advice, Other Physician (rehabilitation, occupational, general), psychologist (clinical psychologist, behavioral therapist), physiotherapist (physical therapist), occupational therapist (ergo therapist), social worker (counsellor, advisor), nurse, other outpatient
Mixed (8)
face-to-face
hospital
NA 8 143 Low
Bilveviciute-Ljungar (2014) b NA NA NA NA
NA
NA
NA
NA NA NA NA
Borys (2015) a To improve functional capacity, reduce pain intensity, improve emotional functioning and well-being, and increase knowledge of bps pain mechanisms and pain related coping strategies. education, exercise, (cognitive) behavioral therapy, pharmacological treatment, body awareness therapy, team meetings Physician (rehabilitation, occupational, general), psychologist (clinical psychologist, behavioral therapist), physiotherapist (physical therapist), social worker (counsellor) inpatient
Mixed
face-to-face
hospital
NA 3 168 Low
Brendbekken (2016) a The application of ISIVET in assessment of health complaints can facilitate patient empowerment and SDM. This may lead to improvements of patient satisfaction, adherence to treatment and better health outcomes. exercise, pain management skills, team meetings Physician (rehabilitation, occupational, general), physiotherapist (physical therapist), social worker (counsellor, advisor) outpatient
Individual
face-to-face, coaching by telephone
hospital
at 12 months f/u: phone contact to use the ISIVET for the last time. NA 815m Low
Cardosa (2012) a aimed at improving daily functional activities and general psychological well-being and pain re-conceptualisation (as chronic but not harmful). education, exercise, (cognitive) behavioral therapy, relaxation, pain management skills, Other Physician (rehabilitation, occupational, general), psychologist (clinical psychologist, behavioral therapist), physiotherapist (physical therapist), nurse, other inpatient
Group
face-to-face
hospital
NA 2 60 NA
De Rooij (2014) a to teach patients to cope with pain and to reduce the interference of pain in their daily lives. education, exercise, (cognitive) behavioral therapy, relaxation, pain management skills, Other Physician (rehabilitation, occupational, general), psychologist (clinical psychologist, behavioral therapist), physiotherapist (physical therapist), occupational therapist (ergo therapist), social worker (counsellor) outpatient
Mixed
face-to-face
treatment/rehabilitation center
  • 4-6 months of tailored individual treatment - 2 optional evaluation sessions
7 49 High
Dysvik (2013) a To improve physiological consequences that may worsen pain; shift focus from pain and disability towards effective coping. education, exercise, pain management skills, body awareness therapy, Other Physician (rehabilitation, occupational, general), psychologist (clinical psychologist, behavioral therapist), physiotherapist (physical therapist), nurse, other outpatient
Group (8-12)
face-to-face, coaching by telephone
hospital
• 2 follow-up sessions (6m and 12m): focus on exercise and education on nutrition and pain, challenges and future plans. Homework on nutrition and health improvements/, thinking on how to continue. 12m was telephone sessions. 8 45 Low
Frost (2000) a to decrease functional disability, increase the patients’ confidence in their ability to carry out normal activities of daily living despite pain, improve general health and psychological status, and increase physical endurance. education, exercise, Other Physician (rehabilitation, occupational, general), psychologist (clinical psychologist, behavioral therapist), physiotherapist (physical therapist) outpatient
Group (maximum of 5)
face-to-face, coaching by telephone
NA
4 full day follow-up sessions , to monitor and maintain progress in exercises, discuss changes in their lifestyle, and any problems that might have arisen 3 9730m Low
Gantschnigg (2017) a Acquire fundamental information about pain (phase 1); learn skills and strategies to cope with pain and increase activity (phase 1,2,3); apply competences in daily life and increase work participation (phase 3). education, exercise, (cognitive) behavioral therapy, relaxation, pain management skills, body awareness therapy, workplace advice Physician (rehabilitation, occupational, general), psychologist (clinical psychologist, behavioral therapist), physiotherapist (physical therapist), occupational therapist (ergo therapist), social worker (counsellor), nurse inpatient and outpatient combined
Mixed
face-to-face
hospital
NA 12 108 Medium
Grahn (2000) a To help patients return to an active, self-reliant life and to facilitate their return to work. Program was based on whole-person perspective with a bio-psycho-social theoretical approach focusing on BAT and cognitivie and relaxation treatment. education, exercise, (cognitive) behavioral therapy, relaxation, pain management skills, body awareness therapy, workplace advice, Other Physician (rehabilitation, occupational, general), physiotherapist (physical therapist), occupational therapist (ergo therapist), nurse, other inpatient
Mixed
face-to-face
treatment/rehabilitation center
at least 3 follow-up meetings (3m 6m 12m), where the patient obtained further advice from the team 4 120 High
Gustafsson (2002) a provide knowledge of FMS and to see pain in a more understandable context; enable participants to cope with pain and related symptoms. education, exercise, relaxation, body awareness therapy, Other Physician (rehabilitation, occupational, general), psychologist (clinical psychologist, behavioral therapist), social worker (counsellor, advisor), nurse outpatient
Mixed (7-8)
face-to-face
hospital
3 day follow-up meeting at 3months. 12 96 Low
Hafenbrack (2013) a Restoration of objective and subjective functional capacity, return to work education, exercise, relaxation, pain management skills, pharmacological treatment, workplace advice Physician (rehabilitation, occupational, general), psychologist (clinical psychologist, behavioral therapist), physiotherapist (physical therapist) outpatient
Group
face-to-face
pain clinic
NA 4 120 NA
Hafenbrack (2013) b NA NA NA NA
NA
NA
NA
NA NA NA NA
Haiduk (2017) a The therapy programme is based on a biopsychosocial model, the concept of salutogenesis, and the integration of various psychotherapeutic concepts and methods. aims to stop the process of pain chronification, to increase resilience, to correct and improve maladaptive coping behaviour, and to improve health-related quality of life. exercise, (cognitive) behavioral therapy, relaxation, pain management skills Physician (rehabilitation, occupational, general), psychologist (clinical psychologist, behavioral therapist), physiotherapist (physical therapist), occupational therapist (ergo therapist), other inpatient
Mixed
face-to-face
hospital
NA 4 108 Low
Hallstam (2016) a NA exercise, (cognitive) behavioral therapy, relaxation, pain management skills, Other Physician (rehabilitation, occupational, general), psychologist (clinical psychologist, behavioral therapist), physiotherapist (physical therapist), nurse outpatient
Mixed
face-to-face
hospital
NA 13 65 Low
Hazard (1988) a NA education, exercise, (cognitive) behavioral therapy, relaxation, pain management skills, Other psychologist (clinical psychologist, behavioral therapist), physiotherapist (physical therapist), occupational therapist (ergo therapist) outpatient
Mixed
face-to-face
treatment/rehabilitation center
NA 3 53 Low
Heikkilä (1998) a to support the patients’ reorientation towards realistic and rewarding goals and to bring the patients back to work graded activity, Other psychologist (clinical psychologist, behavioral therapist), physiotherapist (physical therapist), occupational therapist (ergo therapist), social worker (counsellor, advisor) outpatient
Individual
face-to-face
treatment/rehabilitation center
NA 6 NA Low
Jensen (1997) a Improving pain coping skills in different areas of women’s everyday lives, address sex roles and their influence on our behavior, emphasizing a possible association between pain coping and the traditional female sex role with passivity and helplessness. education, exercise, (cognitive) behavioral therapy, relaxation, pain management skills, Other Physician (rehabilitation, occupational, general), psychologist (clinical psychologist, behavioral therapist), physiotherapist (physical therapist), nurse, other inpatient
Group
face-to-face
pain clinic
NA 5 NA Low
jensen (1997) b NA NA NA NA
NA
NA
NA
• Follow-up phone calls (by nurse) every 6 weeks, for 6 months. NA NA NA
Kääpä (2006) a The goal of the MR was to restore the physical and occupational condition of the patients, improve their skills to cope with pain, and encourage them to take the responsibility for the management of their back pain. education, exercise, (cognitive) behavioral therapy, relaxation, pharmacological treatment, workplace advice Physician (rehabilitation, occupational, general), psychologist (clinical psychologist, behavioral therapist), physiotherapist (physical therapist), occupational therapist (ergo therapist) outpatient
Mixed (6-8)
face-to-face
treatment/rehabilitation center
NA 8 70 Low
Koopman (2004) a Complete return to work exercise, graded activity, (cognitive) behavioral therapy, relaxation, Other Physician (rehabilitation, occupational, general), psychologist (clinical psychologist, behavioral therapist), physiotherapist (physical therapist), other outpatient
Mixed (6-10)
face-to-face
treatment/rehabilitation center
NA 12 216 Low
Lemstra (2005) a NR (evidence for individual components: The primary components of the intervention were submaximal general exercise, education, lifestyle changes, and self-management. The rationale for patient education, behavioral management, stress management, and physical exercise was based on the conclusions of 3 recent systematic literature reviews. There was no rationale, other than possible patient satisfaction, for the dietary or massage interventions.) education, exercise, relaxation, pain management skills, Other Physician (rehabilitation, occupational, general), psychologist (clinical psychologist, behavioral therapist), physiotherapist (physical therapist), other outpatient
Mixed
face-to-face
community center
NA 6 3240m Low
Mangels (2009) a The specific goal of the pain management group (BMR) was to enhance the pain management skills of the patients. education, exercise, relaxation, pain management skills, pharmacological treatment, Other psychologist (clinical psychologist, behavioral therapist), physiotherapist (physical therapist), occupational therapist (ergo therapist) inpatient
Mixed (10-12)
face-to-face
hospital
NA NA 16720m Low
Mangels (2009) b The specific goal of the pain management group (BMR) was to enhance the pain management skills of the patients. education, exercise, relaxation, pain management skills, pharmacological treatment, Other psychologist (clinical psychologist, behavioral therapist), physiotherapist (physical therapist), occupational therapist (ergo therapist) inpatient
Mixed (10-12)
face-to-face, coaching by telephone
hospital
Booster: by telephone NA 16720m Low
Martin (2012) a NA education, exercise, (cognitive) behavioral therapy, relaxation, pain management skills, pharmacological treatment Physician (rehabilitation, occupational, general), psychologist (clinical psychologist, behavioral therapist), physiotherapist (physical therapist) NA
Group (12)
face-to-face
hospital
NA 6 21 NA
McAllister (2005) a Reduce opioid use, decrease pain; reduce healthcare utilization exercise, relaxation, pain management skills, Other Physician (rehabilitation, occupational, general), physiotherapist (physical therapist), nurse inpatient and outpatient combined
Group
face-to-face
NA
NA 4 80 NA
Merrick (2009) a NA education, exercise, (cognitive) behavioral therapy, relaxation, pain management skills, body awareness therapy Physician (rehabilitation, occupational, general), psychologist (clinical psychologist, behavioral therapist), physiotherapist (physical therapist), occupational therapist (ergo therapist), social worker (counsellor, advisor), other outpatient
Mixed
face-to-face
hospital
NA 5 6630m Low
Monticone (2013) a CBT: the purpose was to modify fear of movement beliefs, catastrophizing thinking, and negative feelings, and ensuring gradual reactions to illness behaviors. Exercise: The patients underwent a multimodal motor program consisting of active and passive mobilizations of the spine, and exercises aimed at stretching and strengthening muscles, and improving postural control. education, exercise, (cognitive) behavioral therapy, pain management skills Physician (rehabilitation, occupational, general), psychologist (clinical psychologist, behavioral therapist), physiotherapist (physical therapist) outpatient
Individual
face-to-face, coaching by telephone
treatment/rehabilitation center
for 1 year: monthly 60 minute CBT sessions + telephone reminders to continue exercise 5 15 Low
Monticone (2016) a treatment aimed at managing the fear of movement would induce long-term improvements in disability, kinesiophobia, catastrophizing, pain and QoL in subjects with CLBP. education, exercise, (cognitive) behavioral therapy, relaxation, pain management skills, Other Physician (rehabilitation, occupational, general), psychologist (clinical psychologist, behavioral therapist), physiotherapist (physical therapist) outpatient
Group (5)
face-to-face
treatment/rehabilitation center
NA 5 15 NA
Olason (2004) a One of the main emphases of the program was to gradually withdraw all pain relieving drugs. The focus was on increasing the patients’ physical functioning level and enabling them to return to work. education, exercise, (cognitive) behavioral therapy, relaxation, pain management skills, pharmacological treatment, body awareness therapy, team meetings, Other Physician (rehabilitation, occupational, general), psychologist (clinical psychologist, behavioral therapist), physiotherapist (physical therapist), occupational therapist (ergo therapist), social worker (counsellor, advisor), nurse, other inpatient
Mixed
face-to-face
treatment/rehabilitation center
NA 7 NA Medium
Persson (2012) a increasing patients’ strategies for pain management, activity level, and participation in society. education, exercise, (cognitive) behavioral therapy, relaxation, pain management skills, body awareness therapy, workplace advice, team meetings, Other Physician (rehabilitation, occupational, general), psychologist (clinical psychologist, behavioral therapist), physiotherapist (physical therapist), occupational therapist (ergo therapist), social worker (counsellor, advisor), nurse outpatient
Group (9)
face-to-face
hospital
NA 5 126 NA
Reck (2017) a to restore subjective and objective physical and psychological functioning education, exercise, (cognitive) behavioral therapy, relaxation, pain management skills, workplace advice Physician (rehabilitation, occupational, general), psychologist (clinical psychologist, behavioral therapist), physiotherapist (physical therapist), occupational therapist (ergo therapist) outpatient
Group
face-to-face
pain clinic
NA 1 45 NA
Richardson (1994) a achieving manageable activity levels on tasks of the patient’s own choosing, and of reducing medication intake and pain behaviours. education, exercise, graded activity, (cognitive) behavioral therapy, relaxation, pain management skills, Other psychologist (clinical psychologist, behavioral therapist), physiotherapist (physical therapist), occupational therapist (ergo therapist), nurse, other inpatient and outpatient combined
Group (5)
face-to-face
hospital
NA NA 120 NA
Roche (2011) a the reduction in sick-leave duration achieved by a multidisciplinary program (FRP), based on the bio-psychosocial model, with what could be considered as evidence-based physical treatment in a primary-care environment exercise, relaxation, workplace advice, team meetings, Other Physician (rehabilitation, occupational, general), psychologist (clinical psychologist, behavioral therapist), occupational therapist (ergo therapist) outpatient
Group (6-8)
face-to-face
treatment/rehabilitation center
NA 5 150 Low
Semrau (2014) a The overall objective of PASTOR was the development of active self-management of CLBP through biopsychosocial patient education about low back pain, the introduction of physical activity with an emphasis on promoting positive experiences with exercises and the long-term maintenance of physical activity as well as to promote coping strategies when dealing with CLBP. education, exercise, relaxation, pain management skills Physician (rehabilitation, occupational, general), psychologist (clinical psychologist, behavioral therapist), physiotherapist (physical therapist), social worker (counsellor, advisor) inpatient
Mixed
face-to-face
treatment/rehabilitation center
NA 3 48 Low
Silvemark (2014) a from introduction: Programmes usually have a cognitive behavioural therapy approach, including measures to improve pain behaviour, cognitive restructuring, sleep strategies, stress management, psychosocial training, lifestyle adaptations to pain, pacing, and also physical exercise, ergonomics, body posture and co-ordination, relaxation techniques, Electromyography (EMG)-biofeedback, and strategies to maintain improvements. education, exercise, (cognitive) behavioral therapy, relaxation, pain management skills, body awareness therapy Physician (rehabilitation, occupational, general), psychologist (clinical psychologist, behavioral therapist), physiotherapist (physical therapist), occupational therapist (ergo therapist), social worker (counsellor, advisor), nurse outpatient
Group (6-9)
face-to-face
hospital
NA 5 175 NA
Smeets (2008) a to help patients to identify and cope with the consequences of pain in everyday life than with pain itself. education, graded activity, (cognitive) behavioral therapy, Other Physician (rehabilitation, occupational, general), psychologist (clinical psychologist, behavioral therapist), physiotherapist (physical therapist), occupational therapist (ergo therapist), social worker (counsellor, advisor) outpatient
Group (max 4)
face-to-face
treatment/rehabilitation center
NA 10 2330m Low
smeets (2008) b CT aimed at restoring functional ability through increased fitness, the reinforcement of healthy behaviors and the modification of problem solving abilities. education, exercise, graded activity, (cognitive) behavioral therapy, Other Physician (rehabilitation, occupational, general), psychologist (clinical psychologist, behavioral therapist), physiotherapist (physical therapist), occupational therapist (ergo therapist), social worker (counsellor, advisor) outpatient
Group (max 4)
face-to-face
treatment/rehabilitation center
NA 10 77 Low
spinhoven (2004) a Operant-behavioral treatment aimed at increasing healthy behaviors and decreasing pain behaviors. education, graded activity, (cognitive) behavioral therapy, pain management skills, Other psychologist (clinical psychologist, behavioral therapist), physiotherapist (physical therapist), occupational therapist (ergo therapist) inpatient and outpatient combined
Mixed
face-to-face
treatment/rehabilitation center
NA 8 150 NA
Stein (2013) a The aim of treatment was not to reduce pain but to focus on patients’ quality of life, reduce their drug consumption and maintain or restore their capacity to work education, exercise, (cognitive) behavioral therapy, relaxation, pain management skills, body awareness therapy, team meetings Physician (rehabilitation, occupational, general), psychologist (clinical psychologist, behavioral therapist), physiotherapist (physical therapist), occupational therapist (ergo therapist), other outpatient
Group (6-8)
face-to-face
primary care unit
NA 6 90 NA
Tavafian (2011) NA To improve HRQoL and reduce disability of Iranian patients with CLBP up to 12 months. education, exercise, (cognitive) behavioral therapy, relaxation, pain management skills, pharmacological treatment, Other psychologist (clinical psychologist, behavioral therapist), physiotherapist (physical therapist), other outpatient
Group
face-to-face
university
motivational counseling by phone (for 12 months) / monthly booster sessions Discussing beliefs, knowledge and perception regarding LBP. Promoting healthy behaviors, exercising and negating stressors. • Motivational counseling by phone. Encouraged to cope with the stressors actively to achieve successful adaptation. (for 6 months) 1 9 Low
Thieme (2003) a NA education, exercise, (cognitive) behavioral therapy, pain management skills Physician (rehabilitation, occupational, general), psychologist (clinical psychologist, behavioral therapist), physiotherapist (physical therapist), nurse inpatient
Group (5-7)
face-to-face
hospital
NA 5 75 Low
Van der Maas (2015) a Overall: improve HRQOL, decrease disability and depression. PMT specific: By improving BA, patients learn to recognize body signals other than pain to determine physical and mental states. This will lead to better understanding of bodily information, increasing confidence in body and oneself. increases HRQOL via decreased catastrophizing and increased self-efficacy. education, exercise, graded activity, (cognitive) behavioral therapy, relaxation, Other Physician (rehabilitation, occupational, general), psychologist (clinical psychologist, behavioral therapist), physiotherapist (physical therapist), occupational therapist (ergo therapist) outpatient
Group (4-6)
face-to-face
treatment/rehabilitation center
2x 90min follow-up group sessions to evaluate goals, share experiences, explore solutions and reasons for not achieving goals. New goal setting at fu1, when necessary. 12 94 Low
Van der Maas (2015) b NA education, exercise, graded activity, (cognitive) behavioral therapy, relaxation, body awareness therapy, Other Physician (rehabilitation, occupational, general), psychologist (clinical psychologist, behavioral therapist), physiotherapist (physical therapist), occupational therapist (ergo therapist) outpatient
Group (4-6)
face-to-face
treatment/rehabilitation center
2x90min group follow-up sessions to evaluate goals, share experiences, explore solutions and reasons for not achieving goals. New goal setting at fu1, when necessary. 12 109 Low
van Eijk-Hustings (2013) a to optimise daily functioning through coping with pain and disability. treatment was built around four themes: communication (discover suppressed feelings and emotions); take care of yourself (discover limitations and learn to draw a line); stress, strength, anger and conflict (discover qualities); balance (a new start). education, exercise, graded activity, (cognitive) behavioral therapy, body awareness therapy, Other NA outpatient
Group
face-to-face
treatment/rehabilitation center
up to 7 seven sessions, repeat key messages to presevere behavior change. based on patients requirements. 12 126 Medium
van Hooff (2010) a Increase the ability for self-management and self-efficacy to address the psychological impact of pain. education, exercise, (cognitive) behavioral therapy, relaxation, pain management skills psychologist (clinical psychologist, behavioral therapist), physiotherapist (physical therapist), occupational therapist (ergo therapist) inpatient
Group
face-to-face
Hotel facility, organized by Sint Maartens kliniek Nijmegen
NA 2 100 Low
van Wilgen (2009) a NA education, exercise, graded activity, (cognitive) behavioral therapy, relaxation, pain management skills, Other Physician (rehabilitation, occupational, general), psychologist (clinical psychologist, behavioral therapist), physiotherapist (physical therapist) inpatient and outpatient combined
Mixed
face-to-face
hospital
NA 7 NA High
Vendrig (2000) a Return to work education, exercise, graded activity, pharmacological treatment, workplace advice psychologist (clinical psychologist, behavioral therapist), physiotherapist (physical therapist), other outpatient
Group
face-to-face
treatment/rehabilitation center
NA 4 NA NA
Verkerk (2011) a from a biopsychosocial perspective, application of behavioural principles to adopt adequate normal behavioural movement aimed at physical recovery. education, exercise, relaxation, pain management skills, body awareness therapy Physician (rehabilitation, occupational, general), psychologist (clinical psychologist, behavioral therapist), physiotherapist (physical therapist), other outpatient
Group (6)
face-to-face
treatment/rehabilitation center
• Follow-up session (1): including, evaluation, assessments, training. 9 48 Low
Westman (2009) a to help patients discover possibilities rather then obstacles when returning to work. education, exercise, (cognitive) behavioral therapy, relaxation, body awareness therapy, Other Physician (rehabilitation, occupational, general), psychologist (clinical psychologist, behavioral therapist), physiotherapist (physical therapist), other outpatient
Group (8-10)
face-to-face
primary care setting
NA 8 140 Low
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author year number_of_cohorts cohort_id cohort_name pintens_name_measurement_instrument pintens_pre_m pintens_pre_sd pintens_post_m pintens_post_sd pintens_fu1_m pintens_fu1_sd pintens_fu2_m pintens_fu2_sd pintens_fu3_m pintens_fu3_sd measurements_pain_intensity
Vendrig 2000 1 1 Multidisciplinary behavioural program for chronic pain VAS 45.50 20.7 NA NA 26.20 25.40 23.70 22.30 NA NA Yes
Abbasi 2012 2 1 Spouse Assisted Multidisciplinary pain management program VAS (0-10) 5.00 2.7 3.00 1.80 2.80 2.70 NA NA NA NA Yes
Bendix 2000 1 1 Functional Restoration NPRS 5.10 (IQR: 4-7) NA NA 5.10 NA NA NA NA NA Yes
Borys 2015 1 1 multimodal therapy NRS (0-10) 6.60 2.5 5.10 2.50 5.60 2.50 6.30 2.50 NA NA Yes
Beaudreuil 2010 1 1 Functional restoration program VAS 49.90 15.7 48.70 23.60 40.70 27.80 44.40 23.10 NA NA Yes
De Rooij 2014 1 1 Multidisciplinary treatment programme NRS 6.08 2.08 NA NA 6.08 1.89 5.81 2.33 NA NA Yes
Gantschnigg 2017 1 1 BAI-REHA NRS (0-10) 4.90 2.47 5.11 2.47 5.08 2.15 4.26 2.33 NA NA Yes
Grahn 2000 1 1 Multidisciplinary rehabilitation VAS 39.60 22.8 NA NA 32.00 22.80 NA NA NA NA Yes
Hafenbrack 2013 2 1 Berlin NRS 6.70 1.7 4.70 1.90 4.80 2.10 4.60 2.10 NA NA Yes
Hafenbrack 2013 2 2 Hamburg NRS 6.60 1.9 4.70 2.00 4.50 2.40 4.60 2.30 NA NA Yes
Hallstam 2016 1 1 Multimodal rehabilitation VAS 57.74 20.4 NA NA 49.56 23.90 NA NA NA NA Yes
Jensen 1997 2 1 multimodal cognitive behavioral treatment only (regular intervention) VAS 45.10 20.7 41.00 21.80 48.70 21.30 37.80 25.00 NA NA Yes
jensen 1997 2 2 Multimodal cognitive behavioral treatment (experimental program) VAS 46.80 22 42.50 25.50 46.10 19.80 43.10 25.60 NA NA Yes
Martin 2012 1 1 PSYMEPHY NRS 6.94 1.83 6.48 2.08 6.33 2.22 6.32 2.06 NA NA Yes
McAllister 2005 1 1 Multidisciplinary chronic pain program Likert pain intensity 4.97 0.69 4.43 0.75 4.56 0.84 4.37 0.91 4.53 0.83 Yes
Reck 2017 1 1 Interdisciplinary multimodal pain therapy NRS 4.70 1.83 NA NA 3.70 1.79 4.10 2.28 NA NA Yes
Roche 2011 1 1 Functional Restoration VAS 47.00 21 NA NA 29.00 24.00 NA NA NA NA Yes
Semrau 2014 1 1 PASTOR NRS 5.63 1.66 3.94 1.81 4.22 1.97 NA NA NA NA Yes
Silvemark 2014 1 1 Pain rehabilitation programme MPI: pain severity 4.32 0.79 3.87 0.99 3.60 1.12 NA NA NA NA Yes
Smeets 2008 2 1 Graded activity with problem solving training VAS 48.48 23.51 38.23 23.51 44.40 23.51 45.33 23.51 NA NA Yes
smeets 2008 2 2 combination treatment VAS 45.98 23.95 41.08 23.95 48.15 23.95 51.71 23.95 NA NA Yes
spinhoven 2004 1 1 merged cohorts: operant-behavioral treatment + coping or group discussion (OPCO/OPDI) PRI 23.70 10 21.60 11.50 24.00 12.10 NA NA NA NA Yes
van Wilgen 2009 1 1 Inpatient multidisciplinary CBT programme VAS 52.00 34 34.00 27.00 37.00 32.00 33.00 32.00 NA NA Yes
Verkerk 2011 1 1 Functional recovery VAS 55.50 23 37.00 23.80 35.30 26.10 32.30 26.90 NA NA Yes
Kääpä 2006 1 1 Multidisciplinary rehabilitation program NRS 4.60 1.9 3.30 2.50 3.30 2.50 3.60 2.70 3.50 2.60 Yes
Lemstra 2005 1 1 Multidisciplinary rehabilitation VAS (0-10) 7.14 1.37 6.12 1.37 6.33 1.37 NA NA NA NA Yes
Gustafsson 2002 1 1 multimodal, multidisiciplinary outpatient rehabilitation programme VAS NA NA NA NA NA NA NA NA NA NA Yes
Bendix 1998 2 1 Functional restoration (A) NRS (0-10) 6.10 2.88 NA NA 5.35 2.88 5.50 2.87 6.00 2.78 Yes
Bendix 1998 2 2 Functional restoration (B) NRS 5.00 2.31 NA NA 3.35 2.31 3.75 2.60 4.00 2.60 Yes
Monticone 2013 1 1 Multidisciplinary intervention NRS (0-10) 7.02 1.07 2.69 0.97 1.38 1.07 1.47 1.10 NA NA Yes
Monticone 2016 1 1 multidisciplinary cognitive behavioural rehabilitation programme NRS (0-10) 6.40 1.7 1.40 1.20 2.40 1.50 2.80 1.00 NA NA Yes
Bileviciute-Ljungar 2014 2 1 rehabilitation cohort (1998) VAS 57.75 25.11 NA NA 43.00 28.01 NA NA NA NA Yes
Bilveviciute-Ljungar 2014 2 2 Rehabilitation (2003) VAS 60.25 28.85 NA NA 50.50 25.97 NA NA NA NA Yes
Richardson 1994 1 1 pain management course NRS (0-100) 67.44 18.8 NA NA 64.53 21.86 67.20 19.46 63.67 22.06 Yes
Abbasi 2012 2 2 Patient-oriented multidisciplinary pain management program VAS (0-10) 4.60 2 2.60 2.00 3.70 2.50 NA NA NA NA Yes
Cardosa 2012 1 1 MENANG program NRS (0-10) 6.71 1.64 5.59 1.75 5.20 1.29 5.22 1.35 NA NA Yes
Thieme 2003 1 1 Operant pain therapy MPI: pain severity 4.43 0.98 3.82 0.96 3.66 1.22 3.18 1.27 NA NA Yes
Olason 2004 1 1 interdisciplinary pain management program NRS 6.43 NA 4.72 NA 5.37 NA NA NA NA NA Yes
Stein 2013 1 1 Multidisciplinary rehabilitation NRS (0-10) 6.71 2 NA NA 6.27 2.30 NA NA NA NA Yes